Cardiac resynchronization therapy improves heart rate variability in patients with symptomatic heart failure
Cardiac resynchronization therapy (CRT) using biventricular pacing improves symptoms and functional capacity in patients with moderate to severe heart failure. The present study examined whether an improvement in ventricular performance from resynchronization therapy changes the autonomic control of...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2003-07, Vol.108 (3), p.266-269 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | ADAMSON, Philip B KLECKNER, Karen J VANHOUT, Warren L SRINIVASAN, Sriram ABRAHAM, William T |
| description | Cardiac resynchronization therapy (CRT) using biventricular pacing improves symptoms and functional capacity in patients with moderate to severe heart failure. The present study examined whether an improvement in ventricular performance from resynchronization therapy changes the autonomic control of heart rate.
Heart rate variability (HRV) was examined in 50 patients implanted with the InSync biventricular pacing system who were randomized to therapy-on (n=25) or therapy-off (n=25). HRV was computed as the standard deviation of the atrial cycle length sensed from the system over 2 months of continuous monitoring. HRV was compared between CRT-on and CRT-off groups. HRV was higher in patients randomized to CRT-on compared with CRT-off (148+/-47 ms for CRT-on versus 118+/-45 ms for CRT-off; P=0.02), despite the lack of difference in mean atrial cycle length (844+/-129 ms for CRT-on versus 851+/-110 ms for CRT-off; P=0.82). Changes in plasma catecholamines were not different between the CRT-on and CRT-off groups from baseline to the 3-month follow-up.
Improvement in ventricular performance from CRT shifts cardiac autonomic balance toward a more favorable profile that is less dependent on sympathetic activation. |
| doi_str_mv | 10.1161/01.CIR.0000083368.75831.7A |
| format | Article |
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Heart rate variability (HRV) was examined in 50 patients implanted with the InSync biventricular pacing system who were randomized to therapy-on (n=25) or therapy-off (n=25). HRV was computed as the standard deviation of the atrial cycle length sensed from the system over 2 months of continuous monitoring. HRV was compared between CRT-on and CRT-off groups. HRV was higher in patients randomized to CRT-on compared with CRT-off (148+/-47 ms for CRT-on versus 118+/-45 ms for CRT-off; P=0.02), despite the lack of difference in mean atrial cycle length (844+/-129 ms for CRT-on versus 851+/-110 ms for CRT-off; P=0.82). Changes in plasma catecholamines were not different between the CRT-on and CRT-off groups from baseline to the 3-month follow-up.
Improvement in ventricular performance from CRT shifts cardiac autonomic balance toward a more favorable profile that is less dependent on sympathetic activation.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.CIR.0000083368.75831.7A</identifier><identifier>PMID: 12860899</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adrenergic beta-Antagonists - therapeutic use ; Biological and medical sciences ; Cardiac Pacing, Artificial - methods ; Cardiology. Vascular system ; Catecholamines - blood ; Defibrillators, Implantable ; Echocardiography ; Electrocardiography, Ambulatory ; Female ; Follow-Up Studies ; Heart ; Heart Atria - diagnostic imaging ; Heart Atria - physiopathology ; Heart Failure - diagnosis ; Heart Failure - physiopathology ; Heart Failure - therapy ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Heart Rate ; Humans ; Male ; Medical sciences ; Middle Aged ; Pacemaker, Artificial ; Sympathetic Nervous System - physiopathology ; Treatment Outcome ; Ventricular Dysfunction - physiopathology ; Ventricular Dysfunction - therapy</subject><ispartof>Circulation (New York, N.Y.), 2003-07, Vol.108 (3), p.266-269</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Jul 22 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-72d9389a454fcad3c87da04b881918db90efd136f3bed679a93dff612e93213</citedby><cites>FETCH-LOGICAL-c522t-72d9389a454fcad3c87da04b881918db90efd136f3bed679a93dff612e93213</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15005763$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12860899$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ADAMSON, Philip B</creatorcontrib><creatorcontrib>KLECKNER, Karen J</creatorcontrib><creatorcontrib>VANHOUT, Warren L</creatorcontrib><creatorcontrib>SRINIVASAN, Sriram</creatorcontrib><creatorcontrib>ABRAHAM, William T</creatorcontrib><title>Cardiac resynchronization therapy improves heart rate variability in patients with symptomatic heart failure</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Cardiac resynchronization therapy (CRT) using biventricular pacing improves symptoms and functional capacity in patients with moderate to severe heart failure. The present study examined whether an improvement in ventricular performance from resynchronization therapy changes the autonomic control of heart rate.
Heart rate variability (HRV) was examined in 50 patients implanted with the InSync biventricular pacing system who were randomized to therapy-on (n=25) or therapy-off (n=25). HRV was computed as the standard deviation of the atrial cycle length sensed from the system over 2 months of continuous monitoring. HRV was compared between CRT-on and CRT-off groups. HRV was higher in patients randomized to CRT-on compared with CRT-off (148+/-47 ms for CRT-on versus 118+/-45 ms for CRT-off; P=0.02), despite the lack of difference in mean atrial cycle length (844+/-129 ms for CRT-on versus 851+/-110 ms for CRT-off; P=0.82). Changes in plasma catecholamines were not different between the CRT-on and CRT-off groups from baseline to the 3-month follow-up.
Improvement in ventricular performance from CRT shifts cardiac autonomic balance toward a more favorable profile that is less dependent on sympathetic activation.</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cardiac Pacing, Artificial - methods</subject><subject>Cardiology. Vascular system</subject><subject>Catecholamines - blood</subject><subject>Defibrillators, Implantable</subject><subject>Echocardiography</subject><subject>Electrocardiography, Ambulatory</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Heart Atria - physiopathology</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pacemaker, Artificial</subject><subject>Sympathetic Nervous System - physiopathology</subject><subject>Treatment Outcome</subject><subject>Ventricular Dysfunction - physiopathology</subject><subject>Ventricular Dysfunction - therapy</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkVuLFDEQhYMo7uzqX5BmQd-6za1z8W0Y1F1YENT3UJ1OmCx9M0mvjL_ejNswYF6KpL5TOdRB6JbghhBBPmLSHO6_N_h8FGNCNbJVjDRy_wLtSEt5zVumX6Jd6etaMkqv0HVKj-UqmGxfoytClcBK6x0aDhD7ALaKLp0me4zzFP5ADvNU5aOLsJyqMC5xfnKpOjqIuYqQXfUEMUAXhpBLf6qWonBTTtXvkI9VOo1LnsfyZjeNhzCs0b1BrzwMyb3d6g368eXzz8Nd_fDt6_1h_1DbltJcS9prpjTwlnsLPbNK9oB5pxTRRPWdxs73hAnPOtcLqUGz3ntBqNOMEnaDPjxPLbZ_rS5lM4Zk3TDA5OY1Gcm4wlycwdv_wMd5jVNxZiihkioueIE-PUM2zilF580SwwjxZAg25zgMJqbEYS5xmH9xGLkv4nfbD2s3uv4i3fZfgPcbAMnC4CNMNqQL12LcSsHYX1qElbs</recordid><startdate>20030722</startdate><enddate>20030722</enddate><creator>ADAMSON, Philip B</creator><creator>KLECKNER, Karen J</creator><creator>VANHOUT, Warren L</creator><creator>SRINIVASAN, Sriram</creator><creator>ABRAHAM, William T</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20030722</creationdate><title>Cardiac resynchronization therapy improves heart rate variability in patients with symptomatic heart failure</title><author>ADAMSON, Philip B ; KLECKNER, Karen J ; VANHOUT, Warren L ; SRINIVASAN, Sriram ; ABRAHAM, William T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522t-72d9389a454fcad3c87da04b881918db90efd136f3bed679a93dff612e93213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adrenergic beta-Antagonists - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Cardiac Pacing, Artificial - methods</topic><topic>Cardiology. Vascular system</topic><topic>Catecholamines - blood</topic><topic>Defibrillators, Implantable</topic><topic>Echocardiography</topic><topic>Electrocardiography, Ambulatory</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Heart Atria - physiopathology</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pacemaker, Artificial</topic><topic>Sympathetic Nervous System - physiopathology</topic><topic>Treatment Outcome</topic><topic>Ventricular Dysfunction - physiopathology</topic><topic>Ventricular Dysfunction - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ADAMSON, Philip B</creatorcontrib><creatorcontrib>KLECKNER, Karen J</creatorcontrib><creatorcontrib>VANHOUT, Warren L</creatorcontrib><creatorcontrib>SRINIVASAN, Sriram</creatorcontrib><creatorcontrib>ABRAHAM, William T</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ADAMSON, Philip B</au><au>KLECKNER, Karen J</au><au>VANHOUT, Warren L</au><au>SRINIVASAN, Sriram</au><au>ABRAHAM, William T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiac resynchronization therapy improves heart rate variability in patients with symptomatic heart failure</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2003-07-22</date><risdate>2003</risdate><volume>108</volume><issue>3</issue><spage>266</spage><epage>269</epage><pages>266-269</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Cardiac resynchronization therapy (CRT) using biventricular pacing improves symptoms and functional capacity in patients with moderate to severe heart failure. The present study examined whether an improvement in ventricular performance from resynchronization therapy changes the autonomic control of heart rate.
Heart rate variability (HRV) was examined in 50 patients implanted with the InSync biventricular pacing system who were randomized to therapy-on (n=25) or therapy-off (n=25). HRV was computed as the standard deviation of the atrial cycle length sensed from the system over 2 months of continuous monitoring. HRV was compared between CRT-on and CRT-off groups. HRV was higher in patients randomized to CRT-on compared with CRT-off (148+/-47 ms for CRT-on versus 118+/-45 ms for CRT-off; P=0.02), despite the lack of difference in mean atrial cycle length (844+/-129 ms for CRT-on versus 851+/-110 ms for CRT-off; P=0.82). Changes in plasma catecholamines were not different between the CRT-on and CRT-off groups from baseline to the 3-month follow-up.
Improvement in ventricular performance from CRT shifts cardiac autonomic balance toward a more favorable profile that is less dependent on sympathetic activation.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>12860899</pmid><doi>10.1161/01.CIR.0000083368.75831.7A</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
| subjects | Adrenergic beta-Antagonists - therapeutic use Biological and medical sciences Cardiac Pacing, Artificial - methods Cardiology. Vascular system Catecholamines - blood Defibrillators, Implantable Echocardiography Electrocardiography, Ambulatory Female Follow-Up Studies Heart Heart Atria - diagnostic imaging Heart Atria - physiopathology Heart Failure - diagnosis Heart Failure - physiopathology Heart Failure - therapy Heart failure, cardiogenic pulmonary edema, cardiac enlargement Heart Rate Humans Male Medical sciences Middle Aged Pacemaker, Artificial Sympathetic Nervous System - physiopathology Treatment Outcome Ventricular Dysfunction - physiopathology Ventricular Dysfunction - therapy |
| title | Cardiac resynchronization therapy improves heart rate variability in patients with symptomatic heart failure |
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